The US Capitol Bioterrorism Anthrax Exposures: Clinical Epidemiological and Immunological Characteristics
| Autor: | Lori L. Shatney, Lolita Bebris, Daniel Freilich, Norma L. Graber, Gregory J. Martin, Robert L. Bull, Maria F. Malone, Denise L. Doolan, Jason Dabbs, Mara P. Berzins, John F. Eisold, Alfred J. Mateczun, David L. Blazes, Timothy Burgess, Gary T. Brice |
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| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_treatment
Bacterial Toxins Poison control chemical and pharmacologic phenomena Anthrax Vaccines Monocytes Anthrax Immune system Antigen medicine Humans Immunology and Allergy Lymphocytes Post-exposure prophylaxis Immunization Schedule Spores Bacterial Antigens Bacterial Inhalation Exposure biology business.industry Anthrax Vaccine Adsorbed biology.organism_classification Antibodies Bacterial Bioterrorism Anti-Bacterial Agents Bacillus anthracis Treatment Outcome Infectious Diseases Immunization District of Columbia Immunology biology.protein bacteria Antibody business |
| Zdroj: | The Journal of Infectious Diseases. 195:174-184 |
| ISSN: | 1537-6613 0022-1899 |
| DOI: | 10.1086/510312 |
| Popis: | Background: Bioterrorism-related anthrax exposures occurred at the US Capitol in 2001. Exposed individuals received antibiotics and anthrax vaccine adsorbed immunization. Methods: A prospective longitudinal study of 124 subjects—stratified on the basis of spore exposure, nasopharyngeal culture results, and immunization status from inside and outside an epidemiologically defined exposure zone—was performed to describe clinical outcome and immune responses after Bacillus anthracis exposure. Antibody and cell-mediated immune (CMI) responses to protective antigen (PA) and lethal factor were assayed by enzyme-linked immunosorbent assay and fluorescence-activated cell sorting. Results: Antibody and CMI dose-exposure responses, albeit generally of low magnitude, were seen for unimmunized subjects from inside, within the perimeter, and outside the exposure zone and in nonexposed control subjects. Anti-PA antibody and CMI responses were detected in 94% and 86% of immunized subjects. No associations were seen between symptoms and exposure levels or immune responses. Conclusions: Anthrax spores primed cellular and possibly antibody immune responses in a dose-dependent manner and may have enhanced vaccine boost and recall responses. Immune responses were detected inside the perimeter and outside the exposure zone, which implies more-extensive spore exposure than was predicted. Despite postexposure prophylaxis with antibiotics, inhalation of B. anthracis spores resulted in stimulation of the immune system and possibly subclinical infection, and the greater the exposure, the more complete the immune response. The significance of low-level exposure should not be underestimated. |
| Databáze: | OpenAIRE |
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